Eye Movement Desensitization and Reprocessing (EMDR) therapy is an amazing treatment for trauma. However, it is crucial to assess for dissociation before using EMDR. Dissociation is defined as a psychological defense mechanism that involves a detachment from one’s thoughts, emotions, or sense of identity. Understanding and evaluating the presence of dissociation is vital for ensuring the safety and effectiveness of EMDR therapy.
Below I have some tools on how to assess for dissociation. For a first-level screening, the DES II is recommended. If the score is high or you otherwise still suspect dissociation that did not show up you can then use the MID-60. Both of these tools are accessible via the links below.
I recommend everyone get some training in working with dissociation and integrating parts or ego states work. My experience as an EMDRIA-approved consultant is that most stuck EMDR sessions can be resolved using parts interventions. This is also true for clients without dissociative disorders. We all have some protective parts and many times those parts need some time to prepare for processing. They may be fearful of what happens if trauma is processed.
The assessment process allows us to establish an effective treatment plan for each client. A client that has dissociative tendencies may need additional stabilization work before EMDR processing.
I have an online course on working with complex cases which, includes parts interventions to help with these stuck cases.
Resources for Assessing Dissociation
This shows what areas of dissociation the client is scoring higher on.
This is an instruction sheet to use when using the MID 60
This is a spreadsheet version that the client can fill out
This is a pdf version of the MID-60
Dr. Kate is responsible for many of the resources above and more. She shares it all on her Google Drive.